New research raises concerns about the popular practice of giving most heart patients drugs that reduce the heart’s workload before and after major surgery.
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Guidelines recommend giving beta blocker pills to people at high risk of heart problems if they are undergoing non-cardiac surgery. But hospitals routinely prescribe the drugs to most heart patients, even those at lower risk of complications, who are having an operation. Researchers found that low-risk patients given the drugs were significantly more likely to die.
This is the first observational study to look at how these drugs affect people with varying heart risk factors and supports the idea that beta blockers, which decrease the force of the heart’s pumping action, should continue to be given to high-risk patients who have surgery.
Beta blockers are commonly used to treat high blood pressure and various heart problems and to help prevent complications in heart attack survivors.
Researchers led by Dr. Peter Lindenauer of Baystate Medical Center in Springfield, Mass., analyzed medical records of about 664,000 patients who had a history of heart-related problems and who were having non-cardiac surgery in 2000 and 2001.
Doctors took a sample of that population and found that low-risk patients who received beta blockers had a 43 percent increased risk of death. Beta blocker use was associated with a reduced risk of death in high-risk patients.
The findings were reported in Thursday’s New England Journal of Medicine.
Specialists say two ongoing randomized trials — the gold standard in scientific research — should help determine whether beta blockers pose any risk to low-risk patients.
Until the studies are completed, doctors should continue beta-blocker therapy in low-risk patients, Dr. Don Poldermans of the Erasmus Medical Center in Rotterdam, The Netherlands, wrote in an accompanying editorial. He had no role in the study.
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